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Does a patent foramen ovale influence cognitive function in dialysis patients?

Sudhakar George1, Stephen Holt, Nick Medford

  • 1Clinical Investigations and Research Unit, Brighton and Sussex University Hospitals, Brighton, UK. sudhakargeorge@gmail.com

Nephron. Clinical Practice
|June 6, 2013
PubMed

Insights

Cognitive decline is common in dialysis patients. While a patent foramen ovale (PFO) is a potential factor, it showed minimal impact on cognitive decline over one year in hemodialysis patients.

Area of Science:

  • Nephrology
  • Neurology
  • Cardiology

Background:

  • Patients undergoing dialysis exhibit diminished cognitive function compared to controls.
  • Cerebral microembolisation via a patent foramen ovale (PFO) is a suspected cause.

Purpose of the Study:

  • To assess cognitive decline in hemodialysis (HD) and peritoneal dialysis (PD) patients.
  • To investigate the influence of PFO on cognitive decline in dialysis patients.

Main Methods:

  • Cognitive testing performed on HD and PD patients.
  • Transthoracic echocardiography used to detect PFO.
  • One-year follow-up to compare cognitive changes based on PFO presence and dialysis type.

Main Results:

  • 80 patients (51 HD, 29 PD) were studied; 21% had a PFO.
  • 83% of patients experienced cognitive decline over one year.
  • PD patients showed faster cognitive decline than HD patients; PFO presence had minor effects.

Conclusions:

  • Dialysis patients experience rapid and widespread cognitive decline.
  • The impact of PFO on cognitive decline over one year was subtle.
  • PFO presence should not deter patients from choosing hemodialysis due to concerns about microembolisation.
Abstract

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